Information Collection

10 & 11 - 6 month follow-up surveys

IC 220981 under ICR 201710-0970-002 · OMB 0970-0485.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
10 - 6 Month Follow-up Survey for Sites testing Parenting Intervention_01_20_17.docx	Other-Follow up survey
11 - 6 Month Follow-up Employment Questionnaire Draft 1-20-17.docx	Other-Follow up survey

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Follow up survey			11 - 6 Month Follow-up Employment Questionnaire Draft 1-20-17.docx		Yes	Yes	Fillable Fileable
Other-Follow up survey			10 - 6 Month Follow-up Survey for Sites testing Parenting Intervention_01_20_17.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 810

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	810	810
Annual IC Time Burden (Hours)	540	540
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.